Prostate health for gay men

Today I thought I would introduce the topic of prostate health. The prostate is an important gland for men and their sexual function, however, disease of the prostate impacts on a man’s ability to urinate.

Problems with the prostate can be broken down into three main areas, infection and inflammation, enlargement, and cancer.
Before we do though let’s talk a little about the prostate gland and what it does.

What is the prostate?
The prostate is a gland in males that sits just under the bladder. Its job is to secrete alkaline fluid into the ejaculate or “cum” that helps protect sperm from the acidic environment of the vagina.

The prostate is around the size of a walnut at puberty and is shaped like a doughnut. Through the centre of the doughnut is the urethra, the tube that empties the bladder through the prostate and down to the penis. The prostate slowly grows as men age under the exposure to testosterone from the testes.

Because of its position just under the bladder the prostate can actually be felt via the anus. If you slide a finger into your anus you can feel the prostate; it’s a smooth walnut shaped gland lying on the upper side about the length of the index finger deep.
Because of the prostate’s proximity to the bladder, prostate problems normally cause symptoms associated with passing urine.

One of the most common prostate problems is inflammation, known as prostatitis.
Prostatitis is when the prostate gland has become inflammed. This leads to symptoms with urination in particular:

* needing to pass urine more often
* pain when passing urine
* poor urinary stream
* the sensation of needing to pass urine despite having just gone
* dribbling of urine after going to the bathroom
* sometime there can be pus or blood in the urine
* pain in the groin
* in extreme cases there can be fevers and chills

Prostatitis is quite common with about one in eight men suffering with the symptoms at some time in their life.

The good news is that while it can be very uncomfortable it is rarely life threatening. If you are having extreme pain, fevers or are feeling very unwell, it’s important to see your doctor as soon as possible.

Benign prostatic hyperplasia (BPH) is the medical name for prostate enlargement.
As men age the prostate gland continues to grow.

The prostate gland is covered in a fibrous sheath, so as the prostate grows the tissue is forced inwards which narrows the urethra, the centre part of the prostate which allows urine to drain from the bladder.

This narrowing of the bladder outflow leads to the most common symptoms of BPH:

* difficulty starting urine flow
* needing to strain to pass urine
* decreased urine flow, “not being able to hit the back of the bowl”
* needing to pass urine more frequently
* needing to get up at night to pass urine
* dribbling after finishing passing urine
* urgency, the feeling of needing to pass urine even if urine was just passed

While the good news is that this problem is not life threatening, it can be very annoying. If left untreated it can lead to problems with the bladder and kidneys if extreme.

BPH is quite common with one in seven men suffering between the age of 40-49, increasing to about one in four men by the age of 70.

As mentioned there are a number of natural, medical and surgical options to treat prostate enlargement.

For a fantastic summary check out this great resource from the guys at Andrology Australia.

What is prostate cancer?
Prostate cancer is the most common cancer for men in Australia. Each year more then three thousand men die from prostate cancer, equal to the rate of breast cancer deaths in women.

Prostate cancer occurs when the cells of the prostate start to grow and divide in an unregulated way. This can lead to changes in the function and size of the prostate.

Thankfully prostate cancer is a type that tends to grow quite slowly and tends to stay within the prostate. A small percentage of prostate cancers can be quite aggressive that tend to present earlier, grow faster and spread to other parts of the body.

The main risk factor for prostate cancer is age which is why The Prostate Cancer Foundation of Australia recommend considering screening for prostate cancer at age 40, if you have a significant family history, or from 50 if you do not.

If you are suffering with any of the following symptoms testing is likely to be useful:

* difficulty passing urine, in particular starting or stopping the stream
* poor urine stream (not hitting the back of the bowl)
* dribbling after passing urine
* not being able to fully empty the bladder or needing to get up frequently at night to pass urine
* blood or pus in the urine
* pain in the groin or pelvis

By Dr GEORGE FORGAN-SMITH
General Practitioner

Dr George blogs at www.thehealthybear.com.au